SINGLE ADMINISTRATIVE DOCUMENT

1 DECLARATION Office Code: P02B

2 Exporter /Supplier Address Manila Int'l Container Port
4 4 Manifest No: CCL0024-19
ANHUI JIANGHUAI AUTOMOBILE GROUP CORP. , LTD.
3 Page
NO.176 DONGLIU ROAD, HEFEI, ANHUI 230000 CHINA Customs reference no.: C-184237
1 1 6 Date : 07/03/2019 10:27:43
5 Items 6 Tot Pack 7 Reference Number

4 36 KMPB1900010
8 Importer/Consignee, Address Tin: 009250883000 9 CRF No.
TRIESENBURG AUTO CORPORATION
LOT A 104-105 WESTGATE FILINVEST CENTER, ALABANG
MUNTINLUPA 1799
PHILIPPINES 10 11 12 Tot. F/I/O 13 T. Rel.
XX XX 3,120.00
14 Broker/Attorney-In-Fact, Address Tin: 174655521000 15 Country of Export 15 C.E. Code 17
BERNADINE MORAL LAQUIBLA
UNIT 307 THE CENTENNIAL BLDG. 375 CHINA CN
ESCOLTA ST 291 ZONE 27 BINONDO 16 Country of Origin 17
MANILA1006
PHILIPPINES CHINA
18 Vessel/Aircraft Registry No. 19 Ct 20 Terms Of Delivery
SHENG CANG 2 HAO V. CCL0024-19 0 FOB
245E
21 Local Carrier (If Any) : 22 F. Cur. Total Customs Value 23 Exch Rate 24 Thru Bank

SHENG CANG 2 HAO V. 245E USD 197,080.80 51.358 2

25 26 27 Transhipment Port 28 Financial and Banking Data Bank Code : 998
06/10/2019 XX Terms of Payment : 01-Basic
1
29 Port Of Destination 30 Location Of Goods Bank Name : PCHC
P02B-Manila Int'l Container Port S03 Branch : NA Bank Ref No. : 010140015-0003379

Marks and Numbers - Containers No(s) - Number and Kind 32 Item No. 33 HS Code Rate Tariff Spec
Marks & Nos : N/M 12X40HQ FCL CONTRS
1 87032290000 5.00
No. Of Packages : 6
31 Packages 34 C.O. Code 35 Item Gross Wgt. 36 Pref
and Desc.
Of Goods
Number and Kind : UN-UNIT
CN 6,360.00 Kg(s) ACFTA
Containers No(s) : 37 Procedure Item Net Weight 39 Quota
CCLU7343092, CCLU7750185, CSNU6238634, OOCU7369413,
OOCU7637218 4000 025 6,360.00 Kg(s) NNNNN
- - - - Other
40a AWB/BL 40b Previous Doc No.

CBU JAC SI, 1.3L ENGINE 5MT TRANSMISSION COAU7052315990

OTHInEV : INSinFRT : Fine : 41 Suppl. Units 42 Item Customs Value (F.C.) 43 V.M.
44 Add Infos
Doc / Produ.
1 0.000 0.00
Certif. & Aut.
6.00 25,158.00 1
15,735 + 4,720 + 0 + 1,193 - 15,136
45 Adjustment

Prev Doc Reference : 1.00

46 Dutiable Value (PHP)
Invoice No. : Dump Bond :
18JAC-C0927PH03 1,312,519.43
48 Prepaid Account No. 49 Identification of Warehouse
47 Calcula- Type Tax Base Rate Amount MP
tion of Taxes

CUD 1,312,519.43 5% 65,626.00 1 47b ACCOUNTING DETAILS

.............................................................................................................................
AVT 0.00 1 Mode Of Payment
:
CASH
VAT 1,396,923.47 12% 167,912.00 1 Assessment Number : L-276498 Date : 07/05/2019
Receipt Number : - Date : 07/05/2019
Guarantee : Date :
.............................................................................................................................
Total Fees 7,442.00
Total
233,538.00 Total Assessment 3,575,934.00
50 We hereby certify that the information contained in all pages of this Declaration and the documents submitted are Subscribed and sworn to before me
to the best of out knowledge and belief true and correct.

BERNADINE MORAL LAQUIBLA TRIESENBURG AUTO CORPORATION Administering Officer /

Notary Public
Broker Date : Importer/Attorney-In-Fact

51 AUTHORIZATION 52 Control at Office Destination

Date Print name Position Date Print name Position

This copy is for information purposes only. This is not an official document of the Bureau of Customs and may not be used or relied upon
as basis for compliance with any legal requirement.
 8 Importer/Consignee, Address
1 DECLARATION Office Code: P02B
TRIESENBURG AUTO CORPORATION Manila Int'l Container Port
4 4
LOT A 104-105 WESTGATE FILINVEST CENTER, ALABANG
3 Page
Manifest No: CCL0024-19
MUNTINLUPA 1799 Customs reference no.: C-184237
PHILIPPINES
2 6 Date : 07/03/2019 10:27:43
31 Marks and Numbers - Containers No(s) - Number and Kind 32 Item No. 33 HS Code Rate Tariff Spec
Packages
and Desc. Marks & Nos : 2 87032290000 5.00
Of Goods
No. Of Packages : 3N/M 34 C.O. Code 35 Item Gross Wgt. 36 Pref
Number and Kind : UN-UNIT
CN 3,465.00 Kg(s) ACFTA
Containers No(s) :
37 Procedure Item Net Weight 39 Quota
CCLU7343092, CCLU7750185, CSNU6238634, OOCU7369413, OOCU7637218
- - - - Other 4000 025 3,465.00 Kg(s) NNNNN
40a AWB/BL
CBU JAC S2, 1.5 VVT ENGINE, 5MT TRANSMISSION COAU7052315990
44 Add OTHInEV : INSinFRT : Fine : 41 Suppl. Units 42 Item Customs Value 43 V.M.
Infos Doc 1 0.000
/ Produ.
Certif. &
3.00 15,624.00 1
Aut. 9,772 + 2,932 + 0 + 741 - 9,400 45 Adjustment

1.00
46 Dutiable Value (PHP)
Invoice No. : Dump Bond :
18JAC-C0927PH03 815,120.79
31 Marks and Numbers - Containers No(s) - Number and Kind 32 Item No. 33 HS Code Rate Tariff Spec
Packages
and Desc. Marks & Nos : 3 87032290000 5.00
Of Goods
No. Of Packages : 21 N/M 34 C.O. Code 35 Item Gross Wgt. 36 Pref
Number and Kind : UN-UNIT
CN 24,675.00 ACFTA
Containers No(s) :
37 Procedure Item Net Weight Kg(s) 39 Quota
CCLU7343092, CCLU7750185, CSNU6238634, OOCU7369413, OOCU7637218
- - - - Other 4000 025 24,675.00 NNNNN
40a AWB/BL Kg(s)
CBU JAC S2, 1.5 VVT ENGINE, CVT TRANSMISSION COAU7052315990
44 Add OTHInEV : INSinFRT : Fine : 41 Suppl. Units 42 Item Customs Value 43 V.M.
Infos Doc 1 0.000
/ Produ.
Certif. &
21.00 121,128.00 1
Aut. 75,757 + 22,727 + 0 + 5,746 - 72,876 45 Adjustment

1.00
46 Dutiable Value (PHP)
Invoice No. : Dump Bond :
18JAC-C0927PH03 6,319,375.41
31 Marks and Numbers - Containers No(s) - Number and Kind 32 Item No. 33 HS Code Rate Tariff Spec
Packages
and Desc. Marks & Nos : 4 87032321000 30.00
Of Goods
No. Of Packages : 6 N/M 34 C.O. Code 35 Item Gross Wgt. 36 Pref
Number and Kind : UN-UNIT
CN 7,650.00 Kg(s) ACFTA
Containers No(s) :
37 Procedure Item Net Weight 39 Quota
CCLU7343092, CCLU7750185, CSNU6238634, OOCU7369413, OOCU7637218
- - - - - Of a cylinder capacity exceeding 1,500 cc but not exceeding 1,800 cc 4000 025 7,650.00 Kg(s) NNNNN
40a AWB/BL
CBU JAC S3, 1.6 VVT ENGINE, CVT TRANSMISSION COAU7052315990
44 Add OTHInEV : INSinFRT : Fine : 41 Suppl. Units 42 Item Customs Value 43 V.M.
Infos Doc 1 0.000
/ Produ.
Certif. &
6.00 35,170.80 1
Aut. 21,997 + 6,599 + 0 + 1,668 - 21,160 45 Adjustment

1.00
46 Dutiable Value (PHP)
Invoice No. : Dump Bond :
18JAC-C0927PH03 1,834,897.57
Type Tax Base Rate Amount MP Type Tax Base Rate Amount MP
47 Calcula
-tion of
Taxes
CUD 815,120.79 5% 40,756.00 1 CUD 6,319,375.41 5% 315,968.00 1
AVT 0.00 1 AVT 0.00 1
VAT 867,538.45 12% 104,497.00 1 VAT 6,725,755.06 12% 806,250.00 1

Total first item of this rider: Total second item of this rider:

Type Tax Base Rate Amount MP Type Amount MP < RECAPITULATION

CUD 1,834,897.57 30% 550,469.00 1

AVT 0.00 1
VAT 2,411,618.75 12% 289,558.00 1
C Office of departure

Total third item of this rider:

This copy is for information purposes only. This is not an official document of the Bureau of Customs and may not be used or relied upon
as basis for compliance with any legal requirement.
 53 INTERNAL REVENUE (TAX PER BOX #46 & 47)

TAXABLE VALUE PHP 10,281,912.69 WHARFAGE 9,349.00 OTHERS 1,000.00

BANK CHARGES 0.00
ARRASTRE CHARGES 118,572.00 TOTAL LANDED COST PHP 11,401,835.08
CUSTOMS DUTY 972,819.00
BROKERAGE FEE 17,902.39 DOCUMENTARY STAMP 280.00 TOTAL VAT PHP 1,368,217.00

DESCRIPTION IN TARIFF TERMS SHOULD BE

54 SECTION 55 NO. OF PACKAGES EXAMINATION RETURN 56 DATE RECEIVED 57 DATE RELEASED

ITEM
NO DESCRIPTION IN TARIFF TERMS SHOULD BE QTY UNIT UNIT VALUE TARIFF HEADING RATE

PLEASE REFER TO RIDER/S FOR FINDINGS ON ITHER ITEMS

REVISED CHARGES LIQUIDATION

59 CHARGES 60 DECLARATION 61 FINDINGS 62 DIFFERENCES 65 LIQUIDATION AMOUNT

PHP
DUTY

BIR Taxes
66 SHORT/EXCESS
VAT PHP

Excise Tax/Ad
67 REMARKS

Others

Surcharges

TOTAL

63 ACTION DIRECTED / 64 68
RECOMMENDED
Date Date

69
Date Date

CONTINUATION FROM BOX # 31 FREE DISPOSAL

CUD 972,819.00
AVT 0.00
VAT 1,368,217.00
FIN 1,227,456.00

Total Item Taxes 3,568,492.00

IPF 1,000.00
CDS 250.00
IRS 30.00
CSF 6,162.00
Total Global Taxes 7,442.00
TCNU6877060, MAGU5667053, TGHU6536908, UETU5120865,
3,575,934.00
TCNU3644168, FSCU9344670, CSNU6307000

This copy is for information purposes only. This is not an official document of the Bureau of Customs and may not be used or relied upon
as basis for compliance with any legal requirement.
 Republic of the Philippines
Department of Finance
BUREAU OF CUSTOMS

Terms Of Payment

Code Account

This copy is for information purposes only. This is not an official document of the Bureau of Customs and may not be used or relied upon
as basis for compliance with any legal requirement.
 Bank Reference Number : 010140015-0003379 Selectivity Color : GREEN Section 5
Republic of the Philippines
Department of Finance
BUREAU OF CUSTOMS
ASSESSMENT NOTICE

Customs Office P02B Manila Int'l Container Port

Identification of the Declaration

Ref Registration Assessment Nbr of

Model Year Number Date Year Number Day/Mth Items

4 4 2019 C-184237 07/03/19 2019 L-276498 05/July 4

Declarant Reference No : KMPB1900010

Declarant : 174655521000 BERNADINE MORAL LAQUIBLA
UNIT 307 THE CENTENNIAL BLDG. 375
ESCOLTA ST 291 ZONE 27 BINONDO
MANILA1006
Importer : 009250883000 PHILIPPINES AUTO CORPORATION
TRIESENBURG
LOT A 104-105 WESTGATE FILINVEST CENTER, ALABANG
MUNTINLUPA 1799
PHILIPPINES

Mode of Payment CASH Account Number

Receipt number - Statement number and date

07/05/2019

CUD 972,819.00
AVT 0.00
VAT 1,368,217.00
FIN 1,227,456.00

Total Item Taxes 3,568,492.00

IPF 1,000.00
CDS 250.00
IRS 30.00
CSF 6,162.00
Total Global Taxes 7,442.00

Total assessed amount for the declaration

Amount currently to be paid 3,575,934.00

This copy is for information purposes only. This is not an official document of the Bureau of Customs and may not be used or relied upon
as basis for compliance with any legal requirement.
 TRANSACTION RECEIPT

TRANSACTION RECEIPT NO. KMPB1900010

TRIESENBURG AUTO CORPORATION

CLIENT LOT A 104-105 WESTGATE FILINVEST CENTER, ALABANG MUNTINLUPA 1799
PHILIPPINES

TIN 009250883000

TRANSACTION DETAILS

ENTRY DATE 07/03/2019 00.00.00

ENTRY NO. C-184237

HOUSE NO. COAU7052315990

MANIFEST NO. CCL0024-19

REFERENCE NO. KMPB1900010

AMOUNT 45.00

TOTAL AMOUNT DUE FORTY FIVE PESOS ONLY

Certified correct :

CARGO DATA EXCHANGE CENTER, INC.